尿道板纵切卷管尿道成形术治疗尿道下裂32例临床分析

The clinical analysis of treatment for 32 cases with hypospadias and reelpipe by urethra plate urethroplasty

目的:探讨尿道板纵切卷管尿道成形术治疗尿道下裂的适应证、手术技巧、并发症。方法:对32例尿道下裂患者进行尿道板纵切卷管尿道成形术,其中冠状沟型3例,阴茎体型27例,阴茎阴囊2例。首次手术29例,采用尿道板正中切开卷管;再次手术3例,采用残余尿道板或阴茎皮肤正中切开卷管。卷管长1～9 cm,新尿道采用F6～F10号的多侧孔胃管作为支架管,术后10～14 d拔除。结果:随访0.5～2年,32例中27例一次手术成功,阴茎外观接近生理形态,排尿正常,成功率84.4%。尿瘘4例,均行尿瘘修补术痊愈;尿瘘并尿道狭窄1例,尿道扩张后狭窄改善,尿瘘待手术。结论:尿道板纵切卷管尿道成形术操作简单,治疗效果好,术后阴茎外形美观,是尿道下裂修复术的较好方法。

Objective：To explore the indication, technique and complications of treatment for hypospadias with reelpipe by urethra plate urethroplasty. Methods ：Thirty-two cases with hypospadias including 3 cases of coronary sulcus ,27cases of penis shaft and 2 cases of penis-scrotum were treated with incised plate urethroplasty. Twenty-nine cases were operated using urethra plate medisection,3 cases of reoperation were reelpiped with urethra plate remnants or the skin of penis. The length of pipe was 1 to 9 cm, and F6 or F10 stomach pipe were used as support pipe in new urethral,which was removed at postoperation 10 to 14 days. Results：Follow-up from 6 months to 2 years for the 32 cases,27 were cured upon one operation,and the success rates of surgery were 84.4%. The appearance of penis closed to the physiol0gical form and could urinate normally. Four cases with urine fistula were cured by urine fistula suture, 1 case with urine fistula combined with urethrostenosis was treated with expansion and operation. Conclusions：The incised plate urethroplasty is the first choice for repairing hypospadias because of its operation simple, good corrective effect and shape of the penis.